Reports from the National Institutes of Health and Institute of Medicine recommend strengthening training programs for physicians in the methods of clinical research to translate advances in basic science to improvements in health. This amended application is to renew the training program in "Epidemiology, Clinical Trials and Outcomes Research" established five years ago within the Division of Nephrology at Tufts-New England Medical Center and Tufts University School of Medicine. Andrew S. Levey, MD and Mark Sarnak, MD are the Program Director and Associate Program Director, respectively. The proposed training program is unique in that it combines training by nephrologists with outstanding records in cutting-edge clinical research and by world leaders in epidemiology, biostatistics and health services research. Faculty supervision is complemented by oversight by internal and external advisors, consisting of senior investigators and executives from academia, government and business. The specific aims are as follows: 1) Didactic Training - course work in fulfillment of the MS degree in the Graduate Program in Clinical Research at the Sackler School of Graduate Biomedical Sciences at Tufts University. 2) Independent Study - an hypothesis-based research project supervised by a nephrologist mentor and a research team of faculty with expertise in other disciplines. Nephrology faculty and their collaborators have databases and ongoing studies that can serve as the subject of the trainees'research projects. 3) Training in Presentation - participation in conferences and seminars designed to improve trainees'oral and written presentations. Integration of all aspects of the curriculum with trainees'research projects is ensured by the nephrologist mentors. During the first five years, the Program has evolved to focus on chronic kidney disease, a public health problem affecting more than 20 million adults in the US. All 18 approved trainee positions have been filled. An additional 41 trainee positions have been supported by other sources. Of the 20 trainees who have completed the program, 13 have remained in academic medicine, 5 are in industry or government, and 2 have entered private practice. To date, 50 applications have been received for 2005. Renewal of four training positions per year and addition of one position per year are requested for the next five years